Americans are struggling to pay medical bills and are accumulating medical debt at an increasing rate, according to a survey released by the Commonwealth Fund. The survey found two-thirds of the working-age population was uninsured, underinsured, reported a medical bill problem, or did not get needed healthcare because of cost in 2007. In addition, more than two in five adults in the 19-to-64 age group reported problems paying medical bills or had accumulated medical debt in 2007, up from one in three in 2005. Their difficulties included not being able to afford medical attention when needed, running up medical debts, or having to change their lifestyle to repay medical debts.
A federal judge has blocked California's 10% cut in Medi-Cal fees for doctors, dentists, and pharmacies, saying the measures appear to violate federal law and would worsen medical care for the poor. In the ruling, U.S. District Judge Christina Snyder said she was aware of California's gaping deficit, but she said the state has accepted federal funds for Medi-Cal and is bound to use them to provide quality healthcare to low-income residents. Richard Frankenstein, MD, president of the California Medical Association, said this was the third ruling in five years to conclude that "the state of California has put at risk the access to healthcare for millions of Californians by underfunding the Medi-Cal program."
Commonwealth Medical Group, one of the largest remaining independent physician groups in the Milwaukee area, is breaking up and its 31 physicians are joining Wheaton Franciscan Medical Group or Aurora Advanced Healthcare. Commonwealth Medical Group employs about 200 people and has clinics in seven Wisconsin municipalities. Its physicians all specialize in family-practice or internal medicine. Seventeen of the group's doctors are going to work for Wheaton Franciscan Medical Group and 14 of them are going to work for Aurora Advanced.
The Florida Board of Medicine has decided to drop a fee increase for consumers to get copies of their medical records from doctors. The proposal would have let doctors charge $1 per page, up from the current fee of $1 for the first 25 pages and 25 cents per page after that. A patient needing 100 pages would have paid $100, up from $43.75 now. The rejection of the fee increase comes after 10 months of study, and protests from consumer groups.
North Carolina's state-regulated hospital industry was allowed this year to bid for 41 more patient beds in Wake County, and now three competing hospital groups are vying for regulators' approval. WakeMed, Novant Health, and Rex Health have delivered multi-million dollar plans to the Certificate of Need section of the NC Department of Health and Human Services, which will determine which competitor gets the beds. The contest for the beds will be the first time new hospital capacity has been available in Wake County for the past three years.
It's pretty rare that I have a hard time forming an opinion on any given topic, but I'm conflicted about the latest healthcare marketing controversy. At issue: Should newspapers and hospitals team up to provide healthcare content? A number of arrangements have drawn fire of late—including a newspaper that "sold" its health section to a local hospital, which then provided content for the section, and a TV station that had an exclusive arrangement to run stories that one of its local hospitals suggested.
Now two journalism trade groups have condemned the practice. The Association of Health Care Journalists and the Society of Professional Journalists are urging media outlets to avoid arrangements with hospitals that improperly influence healthcare coverage, calling such partnerships unethical and saying they interfere with independent news coverage of healthcare.
I've been on the fence about this one for a while because I can see both sides so clearly. As a reporter, I cringe at the thought of allowing any organization to influence editorial content, especially if there's money involved. As a reporter who covers healthcare marketing, I think sponsoring a special section on health in the local newspaper is a smart idea.
And it's not like this is anything new: Local newspapers run "advertorial" content all the time. Those wedding, parenting, real estate, and vacation inserts are a vehicle for businesses to promote their services. The articles in those sections aren't hard-hitting news; they're thrown together to make money for both the newspaper and its advertisers.
Apparently, it's OK for florists, baby furniture salesmen, Realtors, and travel agents to make money. But hospitals and health systems are supposed to be above all that. Newspapers, too.
In fact, newspapers and healthcare organizations have a lot in common. They're each a business that has to pretend it's not a business and both industries are struggling financially.
Newspapers and hospitals are both viewed by the public as altruistic organizations that exist first and foremost to serve the public. They shouldn't be in it for the money—hospitals should be saving lives and newspapers should be exposing corruption. They should not be wasting their money on such vulgarities as marketing, advertising, and public relations.
It's as if the public has no notion that it costs money to run a hospital (or a newspaper, for that matter). If no one signs the checks and pays the bills, lives go unsaved and corruption goes unexposed.
So where is the line between right and wrong, here? Unfortunately, there are no easy answers.
You'll probably never convince the public that a hospital is, in fact, a business. But you can't stop marketing and just hope the patients will wander in on their own, either. You can't stop paying the bills and hope the lights stay on.
While I'm figuring it out, I suggest you start being a little more careful with your ad buys. And transparent in your relationships. And go on pretending that your hospital doesn't need money to operate.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
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